Hemichorea-Hemiballism as a Manifestation of Hyperglycemia

Maia, Maria; Moreira, Ana; Gonçalves, Ana Isabel; Santo, João Espírito; Araújo, J. J.

doi:10.7759/cureus.19330

Cited by 5 publications

(3 citation statements)

References 12 publications

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“…Involuntary movements in hyperglycaemic syndromes typically involve the limbs; however, they less commonly affect muscles of the jaw and tongue, and usually are unilateral [ 4 ]. Generally, a significant positive correlation exists between the clinical and imaging findings, with radiological changes occurring usually contralateral to the affected limbs [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

A rare case of hemichorea in the setting of non-ketotic hyperglycaemia with subtle radiological changes: a case report

Clifford

Wakil

2023

Oxford Medical Case Reports

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Movement disorders have been associated with hyperglycaemia including chorea, hemiballismus and choreoathetosis. In almost all documented cases, there is an association between clinical and radiological findings. We report a case of an 82-year-old man with hemichorea in the setting of hyperglycaemia and poorly controlled type 2 diabetes. He had subtle striatal changes on his radiology, and with intravenous fluids and insulin, his involuntary movements resolved on day 4, which correlated with improvement in glycaemic control. He was followed up through our local insulin stabilization programme after discharge.

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Section: Discussionmentioning

confidence: 99%

A rare case of hemichorea in the setting of non-ketotic hyperglycaemia with subtle radiological changes: a case report

Clifford

Wakil

2023

Oxford Medical Case Reports

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“…Acquired, adult-onset chorea/ballism may be due to several causes. Among those, one of the rarest is the nonketotic hyperglycaemia (NKH), a rare and life-threatening complication of a poorly controlled diabetes mellitus (DM), also defined "Diabetic Striatopathy" (DS), because of common findings detected at the T1-weighted sequences magnetic resonance imaging (MRI) scans-hyperintensity of the striatum/putamen (Maia et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

A case of hemichorea associated with nonketotic hyperglycaemia: A new magnetic resonance spectroscopy (MRS) finding and possible future implications

Trinchillo,

Barchetti,

De Joanna

et al. 2023

Clin Physio Funct Imaging

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BackgroundDiabetic Striatopathy (DS) is a rare complication of a poor‐controlled Diabetes Mellitus consisting of sudden onset of movement disorders. To date, there is still poor knowledge about the pathogenesis.CaseWe describe a 79 year old men affected by sudden onset hemichoreic movements whose cause was a non‐ketotic hyperglycaemia diagnosed despite the normal blood glucose levels thanks to brain CT and magnetic resonance imaging. Then, we introduce a new magnetic resonance spectroscopy (MRS) finding never described until today which allowed us to produce a new pathogenetic theory of a phenomenon still without definitive explanations.Literature ReviewWe performed a review of DS cases using the Medline database and we extracted main data regarding imaging findings.ConclusionsThanks to our MRS we show new imaging findings never described until today, with a new pathogenetic explanation, since all the causative hypotheses produced during the past years have never found evidence.

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“…The onset of the disease presents multiple neurological dysfunctions, especially involuntary movements, including hemiballism and hemichorea. The typical neuroimaging features of the contralateral striatum are hyperdensity on CT scans and hyperintensity on T1-weighted MR images [ 2 , 3 ]. In clinical practice, DS has various manifestations.…”

Section: Introductionmentioning

confidence: 99%

Clinical and imaging features of diabetic striatopathy: report of 6 cases and literature review

Shi

Yue

et al. 2022

Neurol Sci

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Objective To explore the clinical manifestations, diagnosis, treatment, and pathogenesis of diabetic striatopathy (DS) to improve the understanding of the disease and avoid misdiagnosis or underdiagnosis. Methods The clinical, laboratory, and imaging data of 6 patients (5 Asian females and 1 Asian male) with diabetic striatum were analyzed retrospectively, and the related literature was reviewed. Results All 6 patients showed hyperglycemia, 5 patients presented with involuntary movement of unilateral limbs, and 1 with unilateral limb numbness. Besides, 5 patients (except case 3) underwent MRI examinations that showed hyperintensity in unilateral caudate and lentiform nucleus on T1-weighted images. And all 6 patients who underwent brain CT examinations showed hyperdensity or isodensity in unilateral caudate and lentiform nucleus. None had a family history of similar abnormal movements. After blood glucose control and symptomatic support treatment, the symptoms of all patients improved to various degrees, and reexaminations showed that the lesions gradually disappeared. Conclusion Diabetic striatal disease is a rare complication of diabetes mellitus, the result of a combination of different pathogenesis. It is characterized by hyperglycemia, hemichorea, and contralateral striatal T1WI hyperintensity or CT hyperdensity. Both ketosis and nonketotic hyperglycemic hemichorea have typical imaging manifestations. The prognosis is excellent when this disease is detected early, and the lesions can be gradually absorbed and dissipated with glycemic control.

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Hemichorea-Hemiballism as a Manifestation of Hyperglycemia

Cited by 5 publications

References 12 publications

A rare case of hemichorea in the setting of non-ketotic hyperglycaemia with subtle radiological changes: a case report

A rare case of hemichorea in the setting of non-ketotic hyperglycaemia with subtle radiological changes: a case report

A case of hemichorea associated with nonketotic hyperglycaemia: A new magnetic resonance spectroscopy (MRS) finding and possible future implications

Clinical and imaging features of diabetic striatopathy: report of 6 cases and literature review

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